Trained as an industrial hygienist and occupational epidemiologist, I have a solid foundation in the methods and skills necessary to recognize work related diseases and exposure. However, to be an academic leader in occupational health, I need to better understand how to prevent occupational disease and exposure. My career development goal is to expand my training in occupational health psychology, intervention research, and the NIOSH cross-sector areas of hearing loss and Total Worker HealthTM (TWHTM). I will accomplish the following career goals: 1.) Learn how individual and organizational factors influence worker exposures and health; 2.) Gain expertise and training in designing, implementing, and evaluating occupational health interventions; 3.) Refine and apply, through a focus on hearing loss, a multi-disciplinary framework for recognizing and preventing occupational diseases integrating industrial hygiene and epidemiological approaches into the evaluation of interventions; and 4.) Use a multi-disciplinary framework to secure grant funding to identify new methods for preventing occupational diseases and creating healthier workplaces. These goals will be accomplished with the support of a strong mentor team including Dr. Martin Cherniack, a physician professor and co-Director of the NIOSH funded Center for the Promotion of Health in the New England Workforce (a TWHTM center), and Dr. Robert Henning, a professor within a robust program in Occupational Health Psychology. In hand with my career development goals, the overall objective of the research proposal is to implement and assess an integrated hearing loss prevention program (IHLPP) delivered through active employee participation. Noise-induced hearing loss (NIHL) remains a pervasive problem in many industries despite regulatory efforts in the United States. My central hypothesis is that an IHLPP that enlists the active participation of employees in training and exposure monitoring and control, and with programmatic integration of health protection with health promotion, will substantially improve hearing conservation program (HCP) effectiveness. Using a randomized design where garages receive either a traditional HCP or IHLPP, the study will be conducted with the Connecticut Department of Transportation, addressing the NORA Transportation, Warehousing and Utilities Sector. This proposal has three specific aims: 1) To evaluate the effectiveness of a participatory approach to training within the TWHTM framework; 2) to evaluate the effectiveness of active participation in noise exposure monitoring and control; and 3) to evaluate the effectiveness of an integrated HCP that protects and promotes total hearing health. Outcomes of this work include the identification of evidence-based program elements for hearing health that enable workers to engage in health protective and promoting behaviors while addressing work and non-work risk factors for hearing loss. Most important, this project seeks to maintain workers' hearing health by reducing noise exposures, increasing health protective and promoting behaviors and ultimately to reduce NIHL.